Saturday, May 28, 2011

Dr. Jane Orient, executive director of AAPS, congressmen Dr. Burgess (TX-R) and Dr. Amerling testified last week before the House in support of freedom of choice for doctors and patients.

This clip is just shy of an hour long but is well worth the time to watch. The PPACA is tragically misnamed: it neither protects patients, nor will it bring down costs. Entitlements are driving federal and state budgets over the cliff, and the PPACA adds significantly to the momentum.These three doctors provide explanations for why this is true.

The new law is specifically designed to disrupt the direct doctor-patient relationship which is the foundation of private practice medicine. This fact is illustrated by what Dr. Berwick, the current head of Medicare, wrote in his book New Rules:

Today, this isolated [doctor-patient] relationship is no longer tenable or possible. Health care has become an industry, with numerous loci of authority well beyond the doctor’s office. In many ways, the relationship of the patient to the doctor is less important. Traditional medical ethics, based on the doctor-patient dyad must be reformulated to fit the new mold of the delivery of health care.

In place of a direct doctor-patient relationship, Berwick advocates (and the PPACA strengthens) our current dysfunctional third party payment system which places a bureaucrat into the middle of our medical decisions. More and more, doctors are being required to make treatment decisions based on population-based clinical guidelines rather than the customized needs of individual patients.

Regulatory requirements are making it more difficult for physicians to survive as small businesses, driving physicians to either retire early or work as employees. It is possible that the physician-as-employee model is less expensive (which is not the same as more efficient or cost-effective,) but shifting to that model should occur voluntarily through a free market, not by the government stacking the deck against the option of private medicine.

For more details on how the new health care control law will take away freedom of choice without solving problem of rising costs, watch the video clip below.
If you prefer to read their statements instead of watch, you can find them here: Dr. Orient's, Dr. Amerling's. I don't have a link to Br. Burgess' statement, but he comes first in the video after a brief introduction by Dr. Orient.

1 comment:

Excellent presentation. Best synopsis I've heard on the status of the new healthcare law for 2014 and why the law seems to be more beneficial to medical insurers than to patients and doctors. The panel even shed light on how insurance companies influence patient care which partially explains why I became a hot potato to doctors and ultimately wound up disabled unnecessarily in my 50s as a result. Perhaps the next discussion could highlight suggestions for actually improving a medical care system that doesn't seem to be working for many chronically ill patients.

After I was fired and lost my insurance for being so ill, I was self-pay. However, doctors' mentality in failing to even try to diagnose or treat me remained the same as if I was a managed care patient. The assembly line analogy for providing care is most certainly a reality. This paradigm allows each doctor to point to some other doctor as responsible for the patient's care. How do you suggest we stop this? Fee for service made no difference in the care I received, although I agree managed care is not the answer nor should insurance companies put walls up between patient and doctor.

Patients don't become chronically ill overnight. If the patient is exercising, eating fairly healthy foods, is not overweight, it stands to reason that the patient became so ill because the underlying cause of disease was overlooked. When this occurs, the disease snowballs like sepsis ultimately affecting the organs.

I've written about my quest for competent care in my blog http://doctorblue.wordpress.com. It gives examples of the medical errors and gamesmanship that occur due to our current system. If you'd like to use any examples in future talks, you may. I'd gladly waive my rights to privacy if I knew it would finally get me the medical care I need.

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